Description:

Issues in individual therapy can affect primary relationships. Therapists should be sensitive to such issues.

Educational Objectives:

1. Describe three ways therapists handle the dilemma of working with individual partners in couples therapy.
2. Describe 3 ways therapists can approach an individual patient who has couples concerns.
3. Indicate how a couple can be empowered even when therapy is with an individual.

*Sessions may be edited for content and to preserve confidentiality*

Outline:

• Introduction and Panel Setup
  The panel opens with a welcome and introduces the topic: the interface between couples and individual therapy. Emphasis is placed on the complexity of therapist dynamics and understanding client systems. Panelists Ellen, Stan, and Bill are introduced, and a PowerPoint on couple-insensitive individual therapy kicks off the session.

• Ellen's Presentation on Couple-Insensitive Individual Therapy
  Individual therapists can destabilize healthy marriages by aligning with negative projections. Clients often cannot accurately represent their partner’s behavior. Therapists must understand relationship dynamics, trauma reenactment, and collaborate effectively with couples therapists.

• Bill's Presentation on Challenges in Individual Therapy for Married Clients
  Building therapeutic alliances without being pulled into biased narratives is key. Therapists should avoid becoming emotional advocates for one partner. Research on undermining practices in individual therapy reveals that certain comments can damage relationships and outcomes.

• Stan's Presentation on the Dyadic Nature of Humans
  Humans are relational and often project aggression onto third parties. Couple therapists must collaborate with all treating professionals. Personal experiences show the challenges of competing with primary attachments. Avoiding therapist undermining and addressing splitting dynamics is critical.

• Inviting Spouses to Individual Sessions
  Spouses should be invited to at least one session for added perspective. This must be set up carefully. Some therapists prefer to avoid seeing individual clients in relationships, focusing instead on the couple system. Understanding the dynamic between individual and couple therapy is emphasized.

• Providing Individual and Couples Therapy by the Same Therapist
  Opinions differ—some avoid it entirely, while others find value in special cases (e.g., when a client is stuck). The key is maintaining focus on the relationship goal and being aware of the risks and boundaries of dual roles.

• Handling Refusals to Consult with Individual Therapists
  Consultation should be included in the treatment agreement. Refusals can be pivotal moments to explore resistance. Flexibility and collaboration are essential when navigating client concerns about therapist communication.

• Domestic Violence and Coercive Control
  Recognizing covert or ego-dystonic abuse is challenging but essential. Coercive control should be addressed in the couple session, as individual sessions may not fully reveal the dynamic. Therapists must remain alert to subtle forms of abuse hidden within the relationship.

• Conclusion and Final Thoughts
  The panel closes with reflections on the ambiguity and complexity of therapy work. Collaboration, flexibility, and systemic awareness are key themes. Ongoing learning and thoughtful engagement with both individual and couple dynamics are encouraged.